Susan K O'Connell, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

102591 Issued in MA

Practice address

740 Main St
Suite 115
Waltham, MA 02451-0607

Phone

(781) 894-8344

NPI assigned

Jan 20, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629121769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 UPLAND RD",
            "city": "NEWTONVILLE",
            "state": "MA",
            "postal_code": "024602422",
            "telephone_number": "781-894-8344",
            "fax_number": "617-527-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 MAIN ST",
            "address_2": "SUITE 115",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024510607",
            "telephone_number": "781-894-8344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNELL",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "102591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0101949000",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1857835",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Nycz, APRN
• Kelley O Connell, PT
• Amanda O'Brien, MS, CCC-SLP
• Kimberly O'Brien, PT
• Shea O'Callaghan, LMFT
• Catherine Imelda O'Connor, PH.D.
• Maryellen O'Connor, D.C.
• Caroline Claire O'Donnell, NP
• Kelsey Margaret O'Donnell, PT
• Elizabeth O'Keefe, RN, CPNP

• Clinical Social Worker in Waltham, MA
• Providers in Waltham, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.